Percutaneous Treatment of Osteoid Osteomas: Combination of Drill Biopsy and Subsequent Ethanol Injection

Osteoid osteoma is known as a benign bone-producing tumor. Histologically, it is characterized by a highly vascularized connective tissue with fibrous bone trabeculae, osteoid, osteoblasts, and numerous osteoclasts. Clinically, patients complain of pain during the night with good response to acetylsalicylic acid. Conventional radiographs show a spindle-shaped lesion with a central lucency not larger than 1 cm in size, which represents the nidus. Osteoid osteomas are most common in the diaphysis of the long bones. A successful therapy requires complete removal of the nidus, either surgically or percutaneously. Our experience is with CT-guided percutaneous drilling of the nidus with subsequent ethanol injection to sclerose remnants of the nidus.